Tag Archives: recovery audit

New CMS RAC Contract Awards Blocked by Federal Court

The U.S. Court of Federal Claims blocked the Centers for Medicare and Medicaid Services (CMS) from awarding new Recovery Audit Contractor (RAC) contracts pending a court appeal filed on August 22, 2014, by CGI Federal (CGI), one of the prospective … Continue reading

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“Finally Friday!” The Return of “Reach-Thru” or “Shadow” Denials – Transmittal 534

Transmittal 505 Resurrected as 534 or “Reach-Thru” Denials Are Back Get the Handouts This week, we looked at the newest wrinkle in what has been termed, “Reach-Thru Denials” and the latest version of a CMS rule that now will “…allow … Continue reading

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The Return of “Reach-Thru Denials” – CMS Transmittal 534

“Reach-Thru” or “Shadow” Denials You Can’t See Them Coming CMS Transmittal 505, issued February 5, 2014 and effective March 6, 2014, modified Section 3.2.3 of the Medicare Program Integrity Manual, to authorize all their various contractors who process and review … Continue reading

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